﻿<%@ Page Title="CUPS Exit" Language="vb" AutoEventWireup="false" MasterPageFile="~/Content/Site.Master" CodeBehind="exit.aspx.vb" Inherits="CupsApp.Web.Form._exit" %>
<%@ Register assembly="wwDataBinder" namespace="MsdnMag.Web.Controls" tagprefix="ww" %>
<%@ Register Assembly="AjaxControlToolkit" Namespace="AjaxControlToolkit" TagPrefix="asp" %>
<asp:Content ID="Content1" ContentPlaceHolderID="head" runat="server">
<link type="text/css" href="../Content/Styles/jquery-ui-1.7.2.custom.css" rel="stylesheet" />
    <script src="../Content/Scripts/jquery-1.3.2.min.js" type="text/javascript"></script>
    <script src="../Content/Scripts/jquery-ui-1.7.2.custom.min.js" type="text/javascript"></script>
	<script type="text/javascript">
	$(function() {
		$(".datepicker").datepicker();
	});
	</script>
</asp:Content>
<asp:Content ID="Content2" ContentPlaceHolderID="ContentPlaceHolder1" runat="server">
<div class="tabs">
 <div class="tab"><asp:LinkButton ID="lnkPersonal" Text = "Personal"  runat="server"   ></asp:LinkButton></div> <div class="tab"><asp:LinkButton ID="lnkBackground" Text = "Background" runat="server"></asp:LinkButton></div> <div class="tab"><asp:LinkButton ID="lnkHealthLegal" Text = "Health / Legal" runat="server"></asp:LinkButton></div> 
 <div class="tab"><asp:LinkButton ID="lnkHousing" Text = "Housing" runat="server"></asp:LinkButton></div><div class="tab"><asp:LinkButton ID="lnkFollowUp" Text = "Follow-Up" runat="server"></asp:LinkButton></div><div class="tab"><asp:LinkButton ID="lnkStatus" Text = "Status" runat="server"></asp:LinkButton></div><div class="tabSelected"><asp:LinkButton ID="lnkExit" Text = "Exit" Enabled = "false" runat="server"></asp:LinkButton></div>
</div>


<div class="Content">
<div class="filler">
         <center> <strong><asp:Label ID="lvlMsg" runat="server" ForeColor="#00CC00" ></asp:Label></strong></center></div><div class="filler"></div>
 
  <div class="FullRow1"> 
    <div class="ContentRow1">
        <asp:Label ID="lblExitDate" runat="server" Text="Exit Date:" ></asp:Label>
    </div>
    <div class="ContentRow2">
        <asp:TextBox ID="txtExitDate" runat="server" CssClass ="datepicker"></asp:TextBox>
    </div>
    <div class="ContentRow1">
    <asp:Label ID="lblClientID" runat="server" Text="Client ID:"></asp:Label>
    </div>
    <div class="ContentRow2">
    <asp:TextBox ID="txtClientID" runat="server"></asp:TextBox>
    </div>
  </div>
   <div class="FullRow1">
     <div class="filler"></div>
     <div class="FormHeading">
         <strong><asp:Label ID="lblBasicInfo" runat="server" Text="BASIC INFORMATION"></asp:Label></strong>
    </div>
  </div> 
  <div class="filler"></div>
   <div class="FullRow1">
    <div class="ContentRow1">
        <asp:Label ID="Label2" runat="server" Text="Salutation:"></asp:Label>
    </div>
    <div class="ContentRow2">
        <asp:TextBox ID="TextBox1" runat="server"></asp:TextBox>
    </div>
    <div class="ContentRow1">
        <asp:Label ID="Label4" runat="server" Text="Suffix:"></asp:Label>
    </div>
    <div class="ContentRow2">
        <asp:TextBox ID="TextBox2" runat="server"></asp:TextBox>
    </div>
  </div> 
  <div class="FullRow1"> 
    <div class="ContentRow1">
        <asp:Label ID="lblFirstName" runat="server" Text="First Name:"></asp:Label>
    </div>
    <div class="ContentRow2">
        <asp:TextBox ID="txtFirstName" runat="server" Text=''></asp:TextBox>
    </div>
    <div class="ContentRow1">
    <asp:Label ID="Label6" runat="server" Text="Last Name:"></asp:Label>
    </div>
    <div class="ContentRow2">
    <asp:TextBox ID="txtLastName" runat="server"></asp:TextBox>
    </div>
  </div>
  <div class="FullRow1">
    <div class="ContentRow1">
        <asp:Label ID="Label7" runat="server" Text="Middle Name:"></asp:Label>
    </div>
    <div class="ContentRow2">
        <asp:TextBox ID="txtMiddleName" runat="server"></asp:TextBox>
    </div>
  </div>   
  <div class="FullRow1">
     <div class="FormHeading">
            <strong><asp:Label ID="lblReasonLeaving" runat="server" Text='Reason For Leaving'></asp:Label></strong>
    </div>
  </div> 
<div class="FullRow1">
    <div class="ContentRow2">
        <asp:CheckBox ID="chkCompleted" runat="server" Text="Completed / Graduated"  />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkCompleted_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkCompleted">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow5">
        <asp:CheckBox ID="chkIncarcerated" runat="server" 
            Text="Incarcerated" />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkIncarcerated_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkIncarcerated">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkDeath" runat="server" Text="Death" />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkDeath_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkDeath">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkUnknown" runat="server" Text="Unknown / Disappeared" />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkUnknown_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkUnknown">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
  </div> 
  <div class="FullRow1"> 
    <div class="ContentRow2">
        <asp:CheckBox ID="chkRefer" runat="server" 
            Text="Referred to Another Program " />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkRefer_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkRefer">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow5">
        <asp:CheckBox ID="chkChoose" runat="server" 
            Text="Chose not to continue with program" />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkChoose_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkChoose">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkOther" runat="server" Text="Other" />
        <asp:MutuallyExclusiveCheckBoxExtender ID="chkOther_MutuallyExclusiveCheckBoxExtender" 
            runat="server" Enabled="True" Key="Completed" TargetControlID="chkOther">
        </asp:MutuallyExclusiveCheckBoxExtender>
    </div>
    <div class="ContentRow2">
    </div>
  </div>
  <div class="FullRow1">
     <div class="FormHeading">
            <strong><asp:Label ID="lblIncome" runat="server" Text="CURRENT SOURCE OF INCOME ( Check all that apply )"></asp:Label></strong>
    </div>
  </div> 
<div class="FullRow1">
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome1" runat="server" Text="AISH" />
    </div>
    <div class="ContentRow5">
        <asp:CheckBox ID="chkIncome2" runat="server" 
            Text="Alberta Works / Income Support" />
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome3" runat="server" Text="Employment Insurance (EI)" />
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome4" runat="server" Text="Pension" />
    </div>
  </div> 
  <div class="FullRow1"> 
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome5" runat="server" Text="Full-time Employment" />
    </div>
    <div class="ContentRow5">
        <asp:CheckBox ID="chkIncome6" runat="server" Text="Part-time Employment" />
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome7" runat="server" Text="No Income" />
    </div>
    <div class="ContentRow2">
        <asp:CheckBox ID="chkIncome8" runat="server" Text="Other" />
    </div>
  </div>
  <div class="FullRow1">
     <div class="FormHeading">
            <strong><asp:Label ID="lblFamilyStatus" runat="server" Text="FAMILY STATUS(EXIT)"></asp:Label></strong>
    </div>
  </div> 
  <div class="FullRow1">
      <asp:CheckBox ID="chkFamilyStatus1" runat="server" Text="Single Parent Family" />
      <asp:MutuallyExclusiveCheckBoxExtender ID="chkFamilyStatus1_MutuallyExclusiveCheckBoxExtender" 
          runat="server" Enabled="True" Key="FamilyStatus" TargetControlID="chkFamilyStatus1">
      </asp:MutuallyExclusiveCheckBoxExtender>
      &nbsp;&nbsp;
      <asp:CheckBox ID="chkFamilyStatus2" runat="server" Text="Two Parent Family" />
      <asp:MutuallyExclusiveCheckBoxExtender ID="chkFamilyStatus2_MutuallyExclusiveCheckBoxExtender" 
          runat="server" Enabled="True" Key="FamilyStatus" TargetControlID="chkFamilyStatus2">
      </asp:MutuallyExclusiveCheckBoxExtender>
      &nbsp;&nbsp;&nbsp;&nbsp;
      <asp:Label ID="lblNumDependants" runat="server" Text="Number of Dependants:"></asp:Label>&nbsp;&nbsp;
      <asp:TextBox ID="txtNumDependants" runat="server"></asp:TextBox>
  </div>
  <div class="FullRow1">
     <hr/>
    <center><asp:Button ID="btnSave" runat="server" Text="Save" Width="83px" /></center>
  </div>
    
  <br />
    <asp:HiddenField ID="Client_ID" runat="server" />
</div>



    <ww:wwDataBinder ID="wwDataBinder1" runat="server">
        <DataBindingItems>
            <ww:wwDataBindingItem runat="server" ControlId="txtClientID" BindingMode="OneWay" 
                BindingSource="_data" BindingSourceMember="ClientID">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem ID="WwDataBindingItem18" runat="server" ControlId="txtExitDate" BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[txtExitDate]">
            </ww:wwDataBindingItem>
             <ww:wwDataBindingItem ID="WwDataBindingItem6" runat="server" ControlId="txtFirstName" BindingMode="OneWay" 
                BindingSource="_data" BindingSourceMember="FirstName">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem ID="WwDataBindingItem7" runat="server" ControlId="txtLastName" BindingMode="OneWay" 
                BindingSource="_data" BindingSourceMember="LastName">
            </ww:wwDataBindingItem>
           
           
            <ww:wwDataBindingItem ID="wwDataBindingItem2" runat="server" BindingMode="TwoWay" 
                BindingSource="_data"  BindingSourceMember="AnswersText[chkCompleted]" ControlId="chkCompleted" BindingProperty="Checked">
            </ww:wwDataBindingItem>
           
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem3"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncarcerated]" ControlId="chkIncarcerated" BindingProperty="Checked">
            </ww:wwDataBindingItem>
           
           <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem4"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkDeath]" ControlId="chkDeath" BindingProperty="Checked">
            </ww:wwDataBindingItem>
             <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem5"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkDisappeared]" ControlId="chkDisappeared" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem1"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome1]" ControlId="chkIncome1" BindingProperty="Checked">
            </ww:wwDataBindingItem>
           <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem8"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome2]" ControlId="chkIncome2" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem9"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome3]" ControlId="chkIncome3" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem10"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome4]" ControlId="chkIncome4" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem11"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome5]" ControlId="chkIncome5" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem12"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome6]" ControlId="chkIncome6" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem13"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome7]" ControlId="chkIncome7" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem14"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkIncome8]" ControlId="chkIncome8" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem15"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkFamilyStatus1]" ControlId="chkFamilyStatus1" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem16"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[chkFamilyStatus2]" ControlId="chkFamilyStatus2" BindingProperty="Checked">
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" ID="wwDataBindingItem17"  BindingMode="TwoWay" 
                BindingSource="_data" BindingSourceMember="AnswersText[txtNumDependants]" ControlId="txtNumDependants" >
            </ww:wwDataBindingItem>
            <ww:wwDataBindingItem runat="server" 
                ControlId="chkFamilyStatus1_MutuallyExclusiveCheckBoxExtender">
            </ww:wwDataBindingItem>
        </DataBindingItems>
    </ww:wwDataBinder>
    
       <asp:ToolkitScriptManager ID="ToolkitScriptManager1" runat="server">
    </asp:ToolkitScriptManager>
    </asp:Content>

